SYLMAR >> The woman Eduardo Tinoco approaches on a recent Sunday morning at a local park visibly stiffens as if she is about to be solicited for money or face an undesirable encounter.

Dressed in a nice shirt and tie, Tinoco tells the young mother in Spanish that something good is happening, and it has to do with health care. He tells her she may qualify for an affordable health plan through the state beginning on Jan. 1. He tells her it’s the law to enroll.

“OK, gracias,” replies the woman, never taking her eyes off her toddler son on the playground.

The woman’s response is common, Tinoco said.

As a state certified outreach counselor, it is his job to educate the public on the Affordable Care Act, to tell them how to learn if they qualify, where to go online, who to call and the information they’ll need to provide to sign up.

But it’s a challenging task, especially in the Latino community which he targets. Tinoco has found that like the general public, many Latinos have some idea of what the Affordable Care Act is about but don’t know how or why it affects them. In addition, he is working among a highly diverse community.

A poll completed in May by Latino Decisions, which conducts opinion research, found that of 800 Latinos surveyed nationwide, 35 percent said they were somewhat informed about the Affordable Care Act, while 31 percent said they were not that informed. But another recent survey completed by the San Francisco-based The Field Poll found that among 1,687 California registered voters surveyed, 79 percent of Latinos expressed a high interest in learning about the Affordable Care Act.

The success of health care reform, especially in California, depends on them.

Of the 2.6 million Californians who qualify for government subsidized health care coverage, nearly half of them are Latino. And the majority live in Los Angeles County.

To reach those who do qualify, community health centers such as Valley Community Clinic in North Hollywood are preparing to release a cadre of outreach workers, especially those who are culturally aware of the community and who understand the various concerns, from fears about immigration to finding and keeping a family doctor.

“We’ve hired a lot of Latinas from within the community who have a background in clinical settings,” said Olga Duran, program director at Valley Community Clinic. “They have been enrolling people in programs for five years. They know the older programs, and they know the new ones.”

Come Oct. 1, outreach workers will go where people congregate, Duran said, from concerts in the park to Little League baseball games to food banks.

“We are trying to make sure the community doesn’t have a lot of anxiety about it,” she said. “We let them know, especially because so many of our population is low income, that they are still eligible for Health Way LA. And for those who are undocumented, we will still provide care. It’s the unknowns that always cause a little bit of angst.”

Sometimes the worries come because of a unique situation: the mixed immigration status of a family. A father may be a legal U.S. citizen, but the mother isn’t. There are 2.2 million undocumented people in California who won’t qualify to enroll in health plans.

The exclusion of many people is an actuarial disaster, said professor David Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at UCLA.

Many of the undocumented immigrants are young, healthy adults with few medical problems — exactly the ones needed to balance and sustain the Affordable Care Act, he said.

“This is the population you want but it’s the one that has been cut down,” he said.

The center, which works to shatter myths and stereotypes about Latinos in California and provides data on Latino health, recently completed a study on Medicare. Researchers found that 35 percent of elderly Latinos were not enrolled in Medicare. Of those, 40 percent replied, “Medicare? Never heard of it,” Hayes-Bautista said.

Those results show the importance of outreach, not only by those hired by community clinics, but within the family. Hayes-Bautista said the center is working on a grant to train college students to become promotoras, or health promoters who will spread the message from the inside out: to their own mothers and uncles, and later, into the community.

Dr. Britt Rios-Ellis, a professor of health sciences at Cal State Long Beach and director of the National Council of La Raza, agrees that promotoras are best when they come from the community. They are more likely to gain what she calls “la confianza” or the trust of people they encounter.

“I think in California, there’s been such great effort in terms of conducting outreach to communities,” Rios-Ellis said. “The other thing I like about the Affordable Care Act is this isn’t just a national health program. It’s also a jobs bill. We’ll be able to see people train to become navigators, promotoras within health care who may go on to be nurses or doctors. This is where we need to go.”

Meanwhile, Tinoco and Maricela Santoyo, also a certified Covered California worker, had set up a booth at Sylmar Park Recreation Center one Sunday, hoping to speak to the parents who had brought their kids to Little League games. Many were polite and accepted brochures, but other parents seemed disinterested. Tinoco said he’s even been asked if he’s earning commission to enroll people into health insurance.

“They only know (the Affordable Care Act) as Obamacare,” Tinoco said. “They want to know if Obama is getting money for this.”

Tinoco said he took on the job of outreach worker because he was raised by a single mom, and their own health care was limited. He doesn’t want to see others go through that.

“People do seem surprised when I tell them about (the Affordable Care Act)” he said. “Some seem excited about it.”

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